Provider Demographics
NPI:1740229673
Name:ALMANSOUR, SARMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:SARMAD
Middle Name:
Last Name:ALMANSOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8889 LAMONT ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5435
Mailing Address - Country:US
Mailing Address - Phone:248-353-4777
Mailing Address - Fax:248-353-4235
Practice Address - Street 1:22972 LAHSER RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-4408
Practice Address - Country:US
Practice Address - Phone:248-353-4777
Practice Address - Fax:248-353-4235
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053934207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4926846Medicaid
MI4931882Medicaid
MIF50556Medicare UPIN
MION93310Medicare PIN